Brits fond of muttering darkly about their country will quickly alight upon the subject of teen pregnancy, at which we excel in Europe (although it’s worth mentioning the UK teen pregnancy rate is at its lowest since the 1960s…so go UK teens!). Depending on their political bent a theory concerning council housing will quickly follow or perhaps fretting about teen girl’s self-worth or sex education. A subject that is rarely brought up in conjunction with teen pregnancy debates is death. Nor, for that matter, are fistulas, incontinence or ruptures mentioned in teen pregnancy discussions. When it comes to health complications brought on by pregnancy a pregnant teen in Britain could be forgiven for thinking this begins and ends with the much feared bucket vagina.

In Liberia teen pregnancy is a huge problem, the young girls’ bodies simply cannot cope with the strain of pregnancy and childbirth. Because of their age, these Liberian girls are likely to have a narrow birth canal, resulting in prolonged labour. In addition to such complications traditional midwives continue to employ unhealthy techniques such as sitting on the belly to speed up the birth. BBC Radio 4’s Today programme has been covering stories in Liberia recently. This week Sarah Montague reported on the acute problems faced by pregnant teenage girls in Liberia, where a third of all babies are born to girls aged between 15 and 19. According to the World Health Organisation (WHO) 994 mothers in 100,000 will die in childbirth, as will 71 of 1000 babies born in Liberia. During Montague’s interviews with the young women at the Bong County healthcare centre she visited a curious similarity between these young girls and some pregnant teens in the UK. A 9 months pregnant 13 year old girl, Gorma, when questioned about her pregnancy said she had seen her friends getting pregnant and had decided to get pregnant too. What does it mean when people exposed to such harsh realities succumb to something so seemingly base as peer pressure? The atrocities of the Ivory Coast have resulted in many young children finding their way to Liberia and having to fend for themselves. Acting Deputy Minister of Social Welfare, Bendu Tulay suggests a lack of parental guidance as well as peer pressure is a factor: “The reason is because, after the war, family structure broke down and children were left cater to themselves. And many of them became early mothers in that process.” Girl children left to cater to themselves would find it necessary to have a boyfriend in the hope of security and support. At Phebes hospital in Bong County there is a Fistula Centre for young girls who are recovering from surgery after having babies so young. There they are taught various skills such as reading, baking bread and sewing. One of the Fistula Centre attendees told the Today programme of how her traditional midwife had not taken her to hospital when complications during birth arose. Her baby died and after an operation to remove the baby she fell into a 3 day coma. A fistula went unnoticed and on her return home the girl was rejected by her friends and family. Save the Children, who have a strong presence in Liberia, say the girls who experience difficulties in childbirth, and survive, will live with a huge stigma when they return home and have difficulty finding a husband. This is because people are well aware that fistulas can reopen and leak, incontinence can be a result of birthing complications and further health problems can arise. It is estimated by WHO that there are between 50,000 and 100,000 new cases of fistula every year. The global treatment capacity is for 20,000 cases a year. Lack of funds in hospitals and poverty has contributed to the suffering endured by teen mothers. It was only recently that user fees were abolished and healthcare made free for mothers and children under 5, partly due to pressure on the government from Save the Children. In 2010 over 200,000 women and children visited the free healthcare clinics. To donate to Save the Children, or to read more about Liberia go here To hear Sarah Montague’s report go here